Reirradiation of Head and Neck Cancers With Proton Therapy: Outcomes and Analyses
Reirradiation of head and neck (H & N) cancer is a clinical challenge. Proton radiation therapy (PRT) offers dosimetric advantages for normal tissue sparing and may benefit previously irradiated patients. Here, we report our initial experience with the use of PRT for H & N reirradiation, with focus on clinical outcomes and toxicity. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - April 13, 2016 Category: Radiology Authors: Jack Phan, Terence T. Sio, Theresa P. Nguyen, Vinita Takiar, G. Brandon Gunn, Adam S. Garden, David I. Rosenthal, Clifton D. Fuller, William H. Morrison, Beth Beadle, Dominic Ma, Mark E. Zafereo, Kate A. Hutcheson, Michael E. Kupferman, William N. William Tags: Clinical Investigation Source Type: research

A novel beam optics concept in a particle therapy gantry utilizing the advantages of superconducting magnets.
CONCLUSIONS: The results show an improvement of its momentum acceptance. Large momentum acceptance in the gantry creates a possibility to implement faster dose application techniques. PMID: 27084590 [PubMed - as supplied by publisher] (Source: Zeitschrift fur Medizinische Physik)
Source: Zeitschrift fur Medizinische Physik - April 12, 2016 Category: Radiology Authors: Gerbershagen A, Meer D, Schippers JM, Seidel M Tags: Z Med Phys Source Type: research

PET-Based Thoracic Radiation Oncology
This article details the current uses of PET/CT in thoracic radiation oncology with a focus on lung cancer and describes expected future roles of PET/CT for thoracic tumors. (Source: PET Clinics)
Source: PET Clinics - April 6, 2016 Category: Radiology Authors: Charles B. Simone, Sina Houshmand, Anusha Kalbasi, Ali Salavati, Abass Alavi Source Type: research

Clinically-applicable Monte Carlo-based biological dose optimization for the treatment of head and neck cancers with spot-scanning proton therapy
A Graphics Processor Unit (GPU)-accelerated and Monte Carlo-based Intensity Modulated Proton Therapy (IMPT) optimizer was used to escalate the biological dose (BD) in small head-and-neck tumors. Compared to conventional IMPT planning, a modest rise in target physical dose can result in a BD enhancement that is several times as large, without additional detriment to critical structures. This optimizer will be used in a feasibility trial on biological optimization, accrual starting in 2016 at our institution. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - April 5, 2016 Category: Radiology Authors: Hok Seum Wan Chan Tseung, Jiasen Ma, Cole R. Kreofsky, Daniel J. Ma, Chris Beltran Tags: Physics Contribution Source Type: research

Clinically Applicable Monte Carlo–based Biological Dose Optimization for the Treatment of Head and Neck Cancers With Spot-Scanning Proton Therapy
Our aim is to demonstrate the feasibility of fast Monte Carlo (MC)–based inverse biological planning for the treatment of head and neck tumors in spot-scanning proton therapy. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - April 5, 2016 Category: Radiology Authors: Hok Seum Wan Chan Tseung, Jiasen Ma, Cole R. Kreofsky, Daniel J. Ma, Chris Beltran Tags: Physics Contribution Source Type: research

Clinically Applicable Monte Carlo –based Biological Dose Optimization for the Treatment of Head and Neck Cancers With Spot-Scanning Proton Therapy
Our aim is to demonstrate the feasibility of fast Monte Carlo (MC) –based inverse biological planning for the treatment of head and neck tumors in spot-scanning proton therapy. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - April 5, 2016 Category: Radiology Authors: Hok Seum Wan Chan Tseung, Jiasen Ma, Cole R. Kreofsky, Daniel J. Ma, Chris Beltran Tags: Physics Contribution Source Type: research

Associations Among Rapid Bedside Anti-Saccade Assessment and Cognitive Function in Children with Craniopharyngioma (P6.212)
Conclusions:If validated in further studies, bedside anti-saccade testing may become a useful tool for identifying children in need of cognitive assessment and/or intervention following brain tumor diagnosis and treatment.Disclosure: Dr. Khan has nothing to disclose. Dr. Conklin has nothing to disclose. Dr. Jason has nothing to disclose. Dr. Russell has nothing to disclose. Dr. Sadighi has nothing to disclose. Dr. Merchant has nothing to disclose. (Source: Neurology)
Source: Neurology - April 4, 2016 Category: Neurology Authors: Khan, R., Conklin, H., Jason, A., Russell, K., Sadighi, Z., Merchant, T. Tags: Behavioral and Cognitive Neurology: Clinical Syndromes Source Type: research

Influence of beam incidence and irradiation parameters on stray neutron doses to healthy organs of pediatric patients treated for an intracranial tumor with passive scattering proton therapy
Proton therapy is one of the external radiation therapy techniques which enables a highly conformal dose delivery to the target volume while sparing organs at risk (OAR) nearby [1]. However, secondary neutrons generated by proton nuclear interactions with beam line elements (called external neutrons) and within the patient himself (called internal neutrons) raise a true concern, especially for pediatric patients, as they increase the lifetime risk of developing a secondary malignancy [2–4]. Thus, experimental measurements [5–7] and Monte Carlo (MC) calculations [8–10] have been extensively used to assess ...
Source: Physica Medica: European Journal of Medical Physics - April 2, 2016 Category: Journals (General) Authors: A. Bonfrate, J. Farah, L. De Marzi, S. Delacroix, J. Hérault, R. Sayah, C. Lee, W.E. Bolch, I. Clairand Tags: Original Paper Source Type: research

Influence of beam incidence and irradiation parameters on stray neutron doses to healthy organs of pediatric patients treated for an intracranial tumor with passive scattering proton therapy.
CONCLUSION: Beam incidence was thus found to induce large variations in stray neutron doses, proving that this parameter could be optimized to enhance the radiation protection of the patient. PMID: 27050170 [PubMed - as supplied by publisher] (Source: Physica Medica)
Source: Physica Medica - April 2, 2016 Category: Physics Authors: Bonfrate A, Farah J, De Marzi L, Delacroix S, Hérault J, Sayah R, Lee C, Bolch WE, Clairand I Tags: Phys Med Source Type: research

Fast multipurpose Monte Carlo simulation for proton therapy using multi- and many-core CPU architectures.
CONCLUSIONS: MCsquare exploits the flexibility of CPU architectures to provide a multipurpose MC simulation tool. Optimized code enables the use of accurate MC calculation within a reasonable computation time, adequate for clinical practice. MCsquare also simulates prompt gamma emission and can thus be used also for in vivo range verification. PMID: 27036568 [PubMed - in process] (Source: Physica Medica)
Source: Physica Medica - April 1, 2016 Category: Physics Authors: Souris K, Lee JA, Sterpin E Tags: Med Phys Source Type: research

ReCAP: Journey Toward High Reliability: A Comprehensive Safety Program to Improve Quality of Care and Safety Culture in a Large, Multisite Radiation Oncology Department.
Abstract QUESTION ASKED: What is the impact of a comprehensive, multifaceted quality and safety improvement program on the frequency of state-reported medical safety events (SRMEs) and overall safety culture in a large, multisite radiation oncology department at the University of Pennsylvania? SUMMARY ANSWER: Multifaceted safety initiatives were implemented at the main academic center and across all network sites at the University of Pennsylvania. A comparison of preintervention and postintervention data demonstrates less frequent SRMEs from 2009-2016 (Fig 1). The Agency for Healthcare Research and Quality (A...
Source: JOP - March 29, 2016 Category: Gastroenterology Authors: Woodhouse KD, Volz E, Maity A, Gabriel PE, Solberg TD, Bergendahl HW, Hahn SM, Woodhouse KD, Volz E, Maity A, Gabriel PE, Solberg TD, Bergendahl HW, Hahn SM Tags: J Oncol Pract Source Type: research

Proton therapy monitoring by Compton imaging: influence of the large energy spectrum of the prompt-γ radiation.
Proton therapy monitoring by Compton imaging: influence of the large energy spectrum of the prompt-γ radiation. Phys Med Biol. 2016 Mar 23;61(8):3127-3146 Authors: Hilaire E, Sarrut D, Peyrin F, Maxim V Abstract In proton therapy, the prompt-γ (PG) radiation produced by the interactions between protons and matter is related to the range of the beam in the patient. Tomographic Compton imaging is currently studied to establish a PG image and verify the treatment. However the quality of the reconstructed images depends on a number of factors such as the volume attenuation, the spatial and ene...
Source: Physics in Medicine and Biology - March 23, 2016 Category: Physics Authors: Hilaire E, Sarrut D, Peyrin F, Maxim V Tags: Phys Med Biol Source Type: research

Establishing cost-effective allocation of proton therapy for breast irradiation
Proton therapy is a costly modality with the potential to reduce cardiac dose in breast irradiation. We conducted cost-effectiveness analyses in women undergoing breast irradiation to determine dosimetric scenarios for which proton therapy would be a high-value option compared to photon therapy, stratifying participants by age and presence of cardiac risk factors. Proton therapy was found to be cost-effective in women with ≥1 cardiac risk factor for mean heart dose ≥ 5 Gy. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - March 19, 2016 Category: Radiology Authors: R. Mailhot Vega, O. Ishaq, A. Raldow, C.A. Perez, R. Jimenez, M. Scherrer-Crosbie, M. Bussiere, A. Taghian, D.J. Sher, S.M. MacDonald Tags: Clinical Investigation Source Type: research

Pathways to improving combined modality therapy for stage III nonsmall-cell lung cancer
Conclusion For locally advanced, inoperable NSCLC, standard therapy has evolved from TRT alone to combined modality therapy. We summarize the recent clinical trial experience and outline promising areas of investigation in an era of greater molecular and immunologic understanding of cancer care. (Source: Annals of Oncology)
Source: Annals of Oncology - March 19, 2016 Category: Cancer & Oncology Authors: Schild, S. E., Vokes, E. E. Tags: reviews Source Type: research

Monte Carlo Calculations Supporting Patient Plan Verification in Proton Therapy
Thiago V. M. Lima, Manjit Dosanjh, Alfredo Ferrari, Silvia Molineli, Mario Ciocca, Andrea Mairani (Source: Frontiers in Oncology)
Source: Frontiers in Oncology - March 18, 2016 Category: Cancer & Oncology Source Type: research

Characterization of a GEM-based scintillation detector with He-CF4 gas mixture in clinical proton beams.
Abstract Accurate, high-spatial resolution dosimetry in proton therapy is a time consuming task, and may be challenging in the case of small fields, due to the lack of adequate instrumentation. The purpose of this work is to develop a novel dose imaging detector with high spatial resolution and tissue equivalent response to dose in the Bragg peak, suitable for beam commissioning and quality assurance measurements. A scintillation gas electron multiplier (GEM) detector based on a double GEM amplification structure with optical readout was filled with a He/CF4 gas mixture and evaluated in pristine and modulated prot...
Source: Physica Medica - March 18, 2016 Category: Physics Authors: Nichiporov D, Coutinho L, Klyachko AV Tags: Phys Med Biol Source Type: research

Comparison of passive-beam proton therapy, helical tomotherapy and 3D conformal radiation therapy in Hodgkin's lymphoma female patients receiving involved-field or involved site radiation therapy.
In this study, we evaluate the potential reduction of dose to normal tissue with helical tomotherapy and proton therapy for Hodgkin's lymphoma involved-field or involved-site irradiation compared to standard 3D conformal radiation therapy. PATIENTS AND METHODS: Fourteen female patients with supradiaphragmatic Hodgkin's lymphoma were treated at our institution with 3D conformal radiation therapy or helical tomotherapy to a dose of 30Gy in 15 fractions. A planning comparison was achieved including proton therapy with anterior/posterior passive scattered beams weighted 20Gy/10Gy. RESULTS: Mean doses to breasts, lung...
Source: Cancer Radiotherapie - March 15, 2016 Category: Cancer & Oncology Authors: Horn S, Fournier-Bidoz N, Pernin V, Peurien D, Vaillant M, Dendale R, Fourquet A, Kirova YM Tags: Cancer Radiother Source Type: research

The influence of physical wedges on penumbra and in-field dose uniformity in ocular proton beams
In ocular proton therapy, physical wedges are used in order to spare a critical tissue, e.g. optic disc or macula, or more usually, to reduce the high dose volume. Approximately half of practising ocular proton therapy centres employ wedges. For example, at the Helmholtz Zentrum Berlin [1] and at The Clatterbridge Cancer Centre (CCC), wedges are used in 70% and 30% of cases respectively. The wedge is usually mounted on the beam collimator by means of a stalk arrangement. It is normal practise to position the wedge as closely as possible to the patient's eye to minimise the effects of proton scatter, but consistent with pat...
Source: Physica Medica: European Journal of Medical Physics - March 14, 2016 Category: Journals (General) Authors: Colin Baker, Andrzej Kacperek Tags: Technical Notes Source Type: research

Risk of second cancers in the era of modern radiation therapy: does the risk/benefit analysis overcome theoretical models?
Abstract In the era of modern radiation therapy, the compromise between the reductions in deterministic radiation-induced toxicities through highly conformal devices may be impacting the stochastic risk of second malignancies. We reviewed the clinical literature and evolving theoretical models evaluating the impact of intensity-modulated radiation therapy (IMRT) on the risk of second cancers, as a consequence of the increase in volumes of normal tissues receiving low doses. The risk increase (if any) is not as high as theoretical models have predicted in adults. Moreover, the increase in out-of-field radiation dos...
Source: Cancer and Metastasis Reviews - March 12, 2016 Category: Cancer & Oncology Source Type: research

National trends and determinants of proton therapy use for prostate cancer: A National Cancer Data Base study
BACKGROUNDIn the current study, the authors sought to both characterize the national trends in proton therapy use for prostate cancer and determine the factors associated with receipt of this limited resource, using what to the best of their knowledge is the largest nationwide cancer registry. METHODSThe National Cancer Data Base was used to identify 187,730 patients diagnosed with nonmetastatic prostate cancer from 2004 through 2012 who received external beam radiotherapy as their initial form of definitive therapy. Multivariable logistic regression analysis adjusted for sociodemographic and clinical factors was used to i...
Source: Cancer - March 11, 2016 Category: Cancer & Oncology Authors: Brandon A. Mahal, Yu‐Wei Chen, Jason A. Efstathiou, Vinayak Muralidhar, Karen E. Hoffman, James B. Yu, Felix Y. Feng, Clair J. Beard, Neil E. Martin, Peter F. Orio, Paul L. Nguyen Tags: Original Article Source Type: research

Dual energy CT in radiotherapy: Current applications and future outlook
Dual energy CT (DECT) scanners are nowadays available in many radiology departments. For radiotherapy purposes, new strategies using DECT imaging are investigated to optimize radiation treatment for multiple steps in the radiotherapy chain. This review describes how DECT based methods can be used for electron density estimation, effective atomic number decomposition and contrast material quantification. Clinical radiotherapy related applications for improved dose calculation accuracy of brachytherapy and proton therapy, metal artifact reduction techniques and normal tissue characterization are also summarized together with...
Source: Radiotherapy and Oncology - March 11, 2016 Category: Radiology Authors: Wouter van Elmpt, Guillaume Landry, Marco Das, Frank Verhaegen Tags: Review Source Type: research

Dual energy CT in radiotherapy: Current applications and future outlook.
Abstract Dual energy CT (DECT) scanners are nowadays available in many radiology departments. For radiotherapy purposes, new strategies using DECT imaging are investigated to optimize radiation treatment for multiple steps in the radiotherapy chain. This review describes how DECT based methods can be used for electron density estimation, effective atomic number decomposition and contrast material quantification. Clinical radiotherapy related applications for improved dose calculation accuracy of brachytherapy and proton therapy, metal artifact reduction techniques and normal tissue characterization are also summar...
Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology - March 11, 2016 Category: Radiology Authors: van Elmpt W, Landry G, Das M, Verhaegen F Tags: Radiother Oncol Source Type: research

Validation of a track repeating algorithm for intensity modulated proton therapy: clinical cases study.
In this study, we present the validation of an efficient dose calculation algorithm for intensity modulated proton therapy, the fast dose calculator (FDC), based on a track-repeating technique. We validated the FDC algorithm for 23 patients, which included 7 brain, 6 head-and-neck, 5 lung, 1 spine, 1 pelvis and 3 prostate cases. For validation, we compared FDC-generated dose distributions with those from a full-fledged Monte Carlo based on GEANT4 (G4). We compared dose-volume-histograms, 3D-gamma-indices and analyzed a series of dosimetric indices. More than 99% of the voxels in the voxelized phantoms describing the patien...
Source: Physics in Medicine and Biology - March 10, 2016 Category: Physics Authors: Yepes PP, Eley JG, Liu A, Mirkovic D, Randeniya S, Titt U, Mohan R Tags: Phys Med Biol Source Type: research

Commissioning and initial experience with the first clinical gantry-mounted proton therapy system
We present our commissioning process and initial clinical experience, including i) CT calibration; ii) beam data acquisition and machine characteristics; iii) dosimetric commissioning of the treatment planning system; iv) validation through the Imaging and Radiation Oncology Core credentialing process, includ­ing irradiations on the spine, prostate, brain, and lung phantoms; v) evaluation of localization accuracy of the image guidance system; and vi) initial clinical experi­ence. Clinically, the system operates well and has provided an excellent platform for the treatment of diseases with protons. (Source: Journal ...
Source: Journal of Applied Clinical Medical Physics - March 8, 2016 Category: Physics Source Type: research

Perturbation of water-equivalent thickness as a surrogate for respiratory motion in proton therapy
Respiratory motion is traditionally assessed using tumor motion magnitude. In proton therapy, respiratory motion causes density variations along the beam path that result in uncertainties of proton range. This work has investigated the use of water-equivalent thickness (WET) to quantitatively assess the effects of respiratory motion on calculated dose in passively scattered proton therapy (PSPT). A cohort of 29 locally advanced non-small cell lung cancer patients treated with 87 PSPT treatment fields were selected for analysis. The variation in WET (ΔWET) along each field was calculated between exhale and inhale phas...
Source: Journal of Applied Clinical Medical Physics - March 8, 2016 Category: Physics Source Type: research

Evaluation of the range shifter model for proton pencil-beam scanning for the Eclipse v.11 treatment planning system
Existing proton therapy pencil-beam scanning (PBS) systems have limitations on the minimum range to which a patient can be treated. This limitation arises from practical considerations, such as beam current intensity, layer spacing, and delivery time. The range shifter (RS) — a slab of stopping material inserted between the nozzle and the patient — is used to reduce the residual range of the incident beam so that the treatment ranges can be extended to shallow depths. Accurate modeling of the RS allows one to calculate the beam spot size entering the patient, given the proton energy, for arbitrary positions and...
Source: Journal of Applied Clinical Medical Physics - March 8, 2016 Category: Physics Source Type: research

Quantitative assessment of anatomical change using a virtual proton depth radiograph for adaptive head and neck proton therapy
The aim of this work is to demonstrate the feasibility of using water-equivalent thickness (WET) and virtual proton depth radiographs (PDRs) of intensity corrected cone-beam computed tomography (CBCT) to detect anatomical change and patient setup error to trigger adaptive head and neck proton therapy. The planning CT (pCT) and linear accelerator (linac) equipped CBCTs acquired weekly during treatment of a head and neck patient were used in this study. Deformable image registration (DIR) was used to register each CBCT with the pCT and map Hounsfield units (HUs) from the planning CT (pCT) onto the daily CBCT. The deformed pC...
Source: Journal of Applied Clinical Medical Physics - March 8, 2016 Category: Physics Source Type: research

Prostate cancer: Proton therapy delays progression
Nature Reviews Urology 13, 181 (2016). doi:10.1038/nrurol.2016.50 Author: Peter Sidaway Patients with prostate cancer often receive treatment with external beam radiation therapy (EBRT); however, this approach can also expose non-malignant tissue to radiation, resulting in adverse events. Now, long-term data are available demonstrating that image-guided proton therapy, which delivers radiation in a more targeted manner, (Source: Nature Reviews Urology)
Source: Nature Reviews Urology - March 8, 2016 Category: Urology & Nephrology Authors: Peter Sidaway Tags: Research Highlight Source Type: research

Pencil beam scanning proton therapy for pediatric intracranial ependymoma
Abstract To assess the clinical outcome and late side effect profile of pencil beam scanning proton therapy (PT) delivered to children with intracranial ependymoma. Between July-2004 and March-2013, 50 patients with intracranial ependymoma (n = 46, grade 3) received involved-field PT at Paul Scherrer Institute (PSI). Median age at time of PT was 2.6 years (range 1.1–15.2). Thirty-six patients had infratentorial and 14 supratentorial ependymomas. Seventeen patients presented with macroscopic residual disease after subtotal resection before starting PT (8 with ≤1.5 cc and 9 with>1.5&n...
Source: Journal of Neuro-Oncology - March 5, 2016 Category: Cancer & Oncology Source Type: research

Image-guided hypofractionated proton beam therapy for low-risk prostate cancer: Analysis of quality of life and toxicity, PCG GU 002
Conclusions Patients treated with hypofractionated proton therapy tolerated treatment well, with excellent QOL scores, persistently low AUA, and no AE grade ≥3. (Source: Reports of Practical Oncology and Radiotherapy)
Source: Reports of Practical Oncology and Radiotherapy - March 4, 2016 Category: Cancer & Oncology Source Type: research

Characterization of the microbunch time structure of proton pencil beams at a clinical treatment facility.
sch G Abstract Proton therapy is an advantageous treatment modality compared to conventional radiotherapy. In contrast to photons, charged particles have a finite range and can thus spare organs at risk. Additionally, the increased ionization density in the so-called Bragg peak close to the particle range can be utilized for maximum dose deposition in the tumour volume. Unfortunately, the accuracy of the therapy can be affected by range uncertainties, which have to be covered by additional safety margins around the treatment volume. A real-time range and dose verification is therefore highly desired and would be k...
Source: Medical Physics - March 4, 2016 Category: Physics Authors: Petzoldt J, Roemer KE, Enghardt W, Fiedler F, Golnik C, Hueso-González F, Helmbrecht S, Kormoll T, Rohling H, Smeets J, Werner T, Pausch G Tags: Phys Med Biol Source Type: research

Dosimetric advantages of proton therapy compared with photon therapy using an adaptive strategy in cervical cancer.
In this study, the potential dosimetric advantages of IGAPT compared with photon-based image-guided adaptive RT (IGART) were investigated. Material and methods For 13 cervical cancer patients, full and empty bladder planning computed tomography (CT) images and weekly CTs were acquired. Based on both primary clinical target volumes (pCTVs) [i.e. gross tumor volume (GTV), cervix, corpus-uterus and upper part of the vagina] on planning CTs, the pretreatment observed full range primary internal target volume (pITV) was interpolated to derive pITV subranges. Given corresponding ITVs (i.e. pITVs including lymph nodes), patient-s...
Source: Acta Oncologica - March 3, 2016 Category: Cancer & Oncology Authors: van de Schoot AJ, de Boer P, Crama KF, Visser J, Stalpers LJ, Rasch CR, Bel A Tags: Acta Oncol Source Type: research

A Monte Carlo study on the collimation of pencil beam scanning proton therapy beams.
CONCLUSIONS: Collimation of PBS beams should be considered for superficial targets particularly for beams delivered through a range-shifter, since the resultant sharpening of the lateral edge will allow improved sparing of adjacent normal tissues. Further work is needed to develop collimators which are integrated into both nozzle designs and planning system optimization algorithms. PMID: 26936730 [PubMed - in process] (Source: Medical Physics)
Source: Medical Physics - March 1, 2016 Category: Physics Authors: Charlwood FC, Aitkenhead AH, Mackay RI Tags: Med Phys Source Type: research

Toward improved target conformity for two spot scanning proton therapy delivery systems using dynamic collimation.
Abstract PURPOSE: To quantify improvement in target conformity in brain and head and neck tumor treatments resulting from the use of a dynamic collimation system (DCS) with two spot scanning proton therapy delivery systems (universal nozzle, UN, and dedicated nozzle, DN) with median spot sizes of 5.2 and 3.2 mm over a range of energies from 100 to 230 MeV. METHODS: Uncollimated and collimated plans were calculated with both UN and DN beam models implemented within our in-house treatment planning system for five brain and ten head and neck datasets in patients previously treated with spot scanning proton thera...
Source: Medical Physics - March 1, 2016 Category: Physics Authors: Moignier A, Gelover E, Smith BR, Wang D, Flynn RT, Kirk ML, Lin L, Solberg TD, Lin A, Hyer DE Tags: Med Phys Source Type: research

Motion-robust intensity-modulated proton therapy for distal esophageal cancer.
CONCLUSIONS: In IMPT for distal esophageal cancer, ΔWET analysis can be used to select the beam angles that are least affected by respiratory and diaphragmatic motion. To further reduce dose deviation, the 4D-robustness optimization can be implemented for IMPT planning. Calculation of DCT0 and DCT50 is a conservative method to estimate the motion-induced dose errors. PMID: 26936698 [PubMed - in process] (Source: Medical Physics)
Source: Medical Physics - March 1, 2016 Category: Physics Authors: Yu J, Zhang X, Liao L, Li H, Zhu R, Park PC, Sahoo N, Gillin M, Li Y, Chang JY, Komaki R, Lin SH Tags: Med Phys Source Type: research

Secondary Neutron Doses to Pediatric Patients During Intracranial Proton Therapy: Monte Carlo Simulation of the Neutron Energy Spectrum and its Organ Doses
Abstract: Proton therapy has the physical advantage of a Bragg peak that can provide a better dose distribution than conventional x-ray therapy. However, radiation exposure of normal tissues cannot be ignored because it is likely to increase the risk of secondary cancer. Evaluating secondary neutrons generated by the interaction of the proton beam with the treatment beam-line structure is necessary; thus, performing the optimization of radiation protection in proton therapy is required. In this research, the organ dose and energy spectrum were calculated from secondary neutrons using Monte Carlo simulations. The Monte Carl...
Source: Health Physics - February 27, 2016 Category: Radiology Tags: Papers Source Type: research

Acute toxicity in comprehensive head and neck radiation for nasopharynx and paranasal sinus cancers: cohort comparison of 3D conformal proton therapy and intensity modulated radiation therapy
To evaluate acute toxicity endpoints in a cohort of patients receiving head and neck radiation with proton therapy or intensity modulated radiation therapy (IMRT). (Source: Radiation Oncology)
Source: Radiation Oncology - February 27, 2016 Category: Cancer & Oncology Authors: Mark W. McDonald, Yuan Liu, Michael G. Moore and Peter A. S. Johnstone Source Type: research

Secondary Neutron Doses to Pediatric Patients During Intracranial Proton Therapy: Monte Carlo Simulation of the Neutron Energy Spectrum and its Organ Doses.
Abstract Proton therapy has the physical advantage of a Bragg peak that can provide a better dose distribution than conventional x-ray therapy. However, radiation exposure of normal tissues cannot be ignored because it is likely to increase the risk of secondary cancer. Evaluating secondary neutrons generated by the interaction of the proton beam with the treatment beam-line structure is necessary; thus, performing the optimization of radiation protection in proton therapy is required. In this research, the organ dose and energy spectrum were calculated from secondary neutrons using Monte Carlo simulations. The Mo...
Source: Health Physics - February 26, 2016 Category: Physics Authors: Matsumoto S, Koba Y, Kohno R, Lee C, Bolch WE, Kai M Tags: Health Phys Source Type: research

Development and evaluation of an online three-level proton vs photon decision support prototype for head and neck cancer – Comparison of dose, toxicity and cost-effectiveness
To quantitatively assess the effectiveness of proton therapy for individual patients, we developed a prototype for an online platform for proton decision support (PRODECIS) comparing photon and proton treatments on dose metric, toxicity and cost-effectiveness levels. An evaluation was performed with 23 head and neck cancer datasets. (Source: Radiotherapy and Oncology)
Source: Radiotherapy and Oncology - February 26, 2016 Category: Radiology Authors: Qing Cheng, Erik Roelofs, Bram L.T. Ramaekers, Daniëlle Eekers, Johan van Soest, Tim Lustberg, Tim Hendriks, Frank Hoebers, Hans Paul van der Laan, Erik W. Korevaar, Andre Dekker, Johannes A. Langendijk, Philippe Lambin Source Type: research

Development and evaluation of an online three-level proton vs photon decision support prototype for head and neck cancer - Comparison of dose, toxicity and cost-effectiveness.
Abstract To quantitatively assess the effectiveness of proton therapy for individual patients, we developed a prototype for an online platform for proton decision support (PRODECIS) comparing photon and proton treatments on dose metric, toxicity and cost-effectiveness levels. An evaluation was performed with 23 head and neck cancer datasets. PMID: 26924342 [PubMed - as supplied by publisher] (Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology)
Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology - February 26, 2016 Category: Radiology Authors: Cheng Q, Roelofs E, Ramaekers BL, Eekers D, van Soest J, Lustberg T, Hendriks T, Hoebers F, van der Laan HP, Korevaar EW, Dekker A, Langendijk JA, Lambin P Tags: Radiother Oncol Source Type: research

Real patient data based cross verification of kilovoltage and megavoltage CT calibration for proton therapy
The accuracy of the predicted beam range is critical for proton therapy treatment planning due to the fast distal fall off of the beam depth dose curve. For each CT simulator a CT Hounsfield Unit (HU) to proton relative stopping power (RSP) calibration needs to be established in order to accurately predict the beam range and calculate 3D dose distribution in proton therapy. High atomic number (Z) materials such as metal implants may restrict the accuracy of proton therapy as they cause significant image artifacts in the surrounding tissue in kilovoltage CT (kVCT) images, which currently is the standard option for radiation...
Source: Physica Medica: European Journal of Medical Physics - February 25, 2016 Category: Journals (General) Authors: Shie Nishioka, Joo Han Park, Wei Zou, Miao Zhang, Ning J. Yue, Ting Chen Tags: Original Paper Source Type: research

Reirradiation of Recurrent and Second Primary Head and Neck Cancer With Proton Therapy
To report clinical outcomes of head and neck reirradiation with proton therapy. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - February 24, 2016 Category: Radiology Authors: M.W. McDonald, O. Zolali-Meybodi, S.J. Lehnert, A.A. Cohen-Gadol, M.G. Moore Tags: Posters Source Type: research

Improving Local Control for Unresectable/Incompletely Resected Sinonasal Cancer With Hyperfractionated Proton Therapy and Concurrent Chemotherapy
Optimal delivery of local therapy for sinonasal cancers has been limited by adjacent anatomic structures resulting in local control (LC) rates of 20% to 40%. The unique physical characteristics of proton therapy (PT) and hyperfractionation can potentially improve outcomes. The purpose of this study is to report outcomes of patients with unresectable/incompletely resected sinonasal cancer treated with hyperfractionated PT and concurrent chemotherapy. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - February 24, 2016 Category: Radiology Authors: R. Dagan, C.M. Bryant, W.M. Mendenhall Tags: Posters Source Type: research

4D dose reconstruction for scanned proton therapy using liver 4DCT-MRI
4DCT-MRI can simulate many 4DCT data sets by combining patient CT with motion extracted from 4DMRI studies. 4DCT-MRI images have been generated using different motion extraction approaches and compared with 4DCT data of liver patients. This method extends the capabilities of motion modeling for accurate 4D dose calculations by accounting for realistic and variable motion patterns. 4DCT-MRI enables plan robustness studies to different motion conditions and 4D dose reconstruction of delivered plan for patient-specific QA. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - February 23, 2016 Category: Radiology Authors: Kinga Bernatowicz, Marta Peroni, Rosalind Perrin, Damian C. Weber, Anthony J. Lomax Tags: Physics Contribution Source Type: research

Four-Dimensional Dose Reconstruction for Scanned Proton Therapy Using Liver 4DCT-MRI
Four-dimensional computed tomography-magnetic resonance imaging (4DCT-MRI) is an image-processing technique for simulating many 4DCT data sets from a static reference CT and motions extracted from 4DMRI studies performed using either volunteers or patients. In this work, different motion extraction approaches were tested using 6 liver cases, and a detailed comparison between 4DCT-MRI and 4DCT was performed. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - February 23, 2016 Category: Radiology Authors: Kinga Bernatowicz, Marta Peroni, Rosalind Perrin, Damien C. Weber, Antony Lomax Tags: Technological Advances Source Type: research

A neural network-based 2D/3D image registration quality evaluator for pediatric patient setup in external beam radiotherapy.
Abstract Our purpose was to develop a neural network-based registration quality evaluator (RQE) that can improve the 2D/3D image registration robustness for pediatric patient setup in external beam radiotherapy. Orthogonal daily setup X-ray images of six pediatric patients with brain tumors receiving proton therapy treatments were retrospectively registered with their treatment planning computed tomography (CT) images. A neural network-based pattern classifier was used to determine whether a registration solution was successful based on geometric features of the similarity measure values near the point-of-solution...
Source: Journal of Applied Clinical Medical Physics - February 20, 2016 Category: Physics Authors: Wu J, Su Z, Li Z Tags: J Appl Clin Med Phys Source Type: research

[Localized prostate cancer : Radiotherapeutic concepts].
CONCLUSIONS: Three-dimensional conformal radiotherapy has long been the standard of care for percutaneous radiotherapy. The development of intensity-modulated radiation therapy (IMRT) and image-guided radiation therapy (IGRT) have increased the precision of treatment, thus, reducing side effects and allowing dose escalation. LDR (low dose rate) and HDR (high dose rate) brachytherapy alone or in combination are a treatment option in localized prostate cancer with a distinct side effect profile. The roles of proton therapy and stereotactic radiotherapy should be further investigated in prospective trials. PMID: 26895435...
Source: Der Urologe. Ausg. A - February 19, 2016 Category: Urology & Nephrology Authors: Grimm M, Wenz F Tags: Urologe A Source Type: research

The management of head and neck tumors with high technology radiation therapy.
Authors: Mendez LC, Moraes FY, Poon I, Marta GN Abstract Squamous cell carcinoma is responsible for 90% of the head and neck cancers affecting over 600,000 people worldwide. Radiation therapy, surgery and chemotherapy are the most important treatment modalities in head and neck squamous cell carcinoma. The aim of this review is to summarize the recent innovations in head and neck radiation therapy, which intends to appreciate the cutting-edge intensity-modulated radiation therapy strategies to mitigate long-term toxicities and evaluate promising technologies in the field as adaptive treatment, dose painting and pro...
Source: Expert Review of Anticancer Therapy - February 17, 2016 Category: Cancer & Oncology Tags: Expert Rev Anticancer Ther Source Type: research